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Abstract
Both local and systemic infections may complicate the morbidity of patients with oral
malignant neoplasms, particularly those presenting intraorally. This study investigated
the microbial contents of the biofilms present on the surfaces of oral squamous cell
carcinomas. Biofilm samples were obtained from the central surface of the lesions
in 21 patients (20 male, 1 female) aged 52.8 (+/- 8.2) years, and from contiguous
healthy mucosa, before any antibiotic therapy or any tumour treatment. All lesions
were keratinising squamous cell carcinomas with surface ulceration. Samples were transported
in reduced brain heart infusion (BHI) broth and cultured within 1 h of removal, using
aerobic and anaerobic complete and selective media. The median number of anaerobic
colony forming units (CFU/ml) at the tumour sites (1.6 x 10(8)) was significantly
higher than for the healthy (control) mucosa (3.0 x 10(7); P = 0.0001, Wilcoxon);
the same was true for aerobes at the tumour sites (1.51 x 10(8)) relative to the controls
(2.8 x 10(7); P = 0.0008, Wilcoxon). The species isolated in increased numbers at
tumour sites were Veillonella, Fusobacterium, Prevotella, Porphyromonas, Actinomyces
and Clostridium (anaerobes), and Haemophilus, Enterobacteriaceae and Streptococcus
spp. (aerobes). Candida albicans was found at eight of the 21 tumour sites, but never
at control sites. It was concluded that human oral carcinoma surface biofilms harbour
significantly increased numbers of aerobes and anaerobes as compared with the healthy
mucosal surface of the same patient. Candida albicans can also be present in these
biofilms. These findings must be considered in relation to the known predisposition
of such patients to systemic infections, and to the unpleasant complications of oral
morbidity due to infected lesions.